Healthcare Provider Details

I. General information

NPI: 1831001460
Provider Name (Legal Business Name): FUNCTION WELLNESS LAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 SHOAL CREEK BLVD
AUSTIN TX
78757-7525
US

IV. Provider business mailing address

8301 SHOAL CREEK BLVD
AUSTIN TX
78757-7525
US

V. Phone/Fax

Practice location:
  • Phone: 972-890-4743
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: HEATHER VANRIPER
Title or Position: OWNER
Credential:
Phone: 972-890-4743